A group of more than 70 psychologists, psychiatrists and mental health professionals sent a letter to President Donald Trump’s physician on Thursday, imploring him to include an evaluation of the president’s neurological health in a physical examination scheduled for Friday.

The White House has said tests of mental fitness will not be part of the president’s physical. Press secretary Sarah Huckabee Sanders said on Thursday that the physician, Rear Adm. Ronny Jackson, would issue a statement following the exam and answer questions from the media next week.

Story Continued Below

A president's cognitive functions are not typically tested during a physical, though such tests are advised for people Trump’s age — 71 — during annual checkups.

“Your duty to this patient and the country that employs you as an officer of the United States Navy is to refer your patient to specialist care if any elements of your neurological and psychiatric examination yield pertinent results,” reads the letter, which was provided to POLITICO. “Your threshold for such referral should be low given this patient’s position.”

The letter comes amid questions about the president’s mental state following the recent publication of Michael Wolff’s tell-all book, which describes Trump’s erratic behavior and quotes top officials questioning his competence on the record.

Steven Buser, a psychiatrist and a signatory on the letter, formerly served in the Air Force, where he conducted psychiatric exams on airmen, including those tasked with duties involving the nuclear arsenal. That background has fueled his concern, he said.

“My biggest concern has really been the whole nuclear threat,” said Buser, who co-edited the book, “A Clear and Present Danger: Narcissism in the Era of Donald Trump.”

The most reliable politics newsletter.

Sign up for POLITICO Playbook and get the latest news, every morning — in your inbox.

Email

By signing up you agree to receive email newsletters or alerts from POLITICO. You can unsubscribe at any time.

“Our entire nuclear chain of command is held through DOD regulations to the highest standard of psychological well-being … except the man who has his very finger on the nuclear button,” he added.

The letter writers did not offer any diagnosis, but suggested that Trump had behaved in such a way that an examination was merited.

David M. Reiss, a California psychiatrist and a contributor to the book, “The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President,” and a signatory on the letter, said Trump’s pattern of behavior has been “disturbing, and it’s worrisome, and it really needs attention.”

“It’s important for the public to see that these are concerns a lot of people have and understand our reasons and motivations,” he said.

The letter is being promoted by Tom Steyer, the liberal mega-donor and environmentalist who has been a leading voice in calls to impeach Trump. He recently pledged $30 million on the 2018 midterm elections with the goal of “removing this president,” and has run television ads calling for Trump’s impeachment.

Steyer’s team was approached about the letter by John Gartner, a psychologist who founded Duty to Warn, a group that calls for Trump to be removed from office because he is, according to the group, “psychologically unfit.”

“There’s a fitness question for this president,” Steyer told POLITICO, describing his role as “amplifying the voice of professionals in this field.”

Some Democrats have introduced legislation that would require the president to undergo a mental health evaluation.